Diabetes

COVID-19 infection may increase risk of type 1 diabetes, suggests nationwide study of 1.2 million children

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According to new research presented at the European Association for the Study of Diabetes Annual Meeting in Stockholm, Sweden (19-23 September), children and adolescents who test positive for SARSCoV-2, the virus which causes COVID-19, are more likely to develop type 1 diabetes. The study is by Hanne Løvdal Gulseth and Dr. German Tapia, Norwegian Institute of Public Health, Oslo, Norway, and colleagues.

The study used national health records to examine new onset type one diabetes diagnoses made in Norway’s under-18s (over 1.2million individuals) over the course 2 years. It began on March 1, 2020 and ended on March 1, 2020. It compared COVID-19-infected people with those who didn’t.

“Our nationwide study suggests a possible association between COVID-19 and new-onset type 1 diabetes,” says Dr. Hanne Løvdal Gulseth, lead author and Research Director at the Norwegian Institute of Public Health. “However the absolute risk of developing type-1 diabetes increased from 0.08 to 0.13%, but it is still low. Although the majority of COVID-19-positive teenagers will not develop type 1, it is important that parents and doctors are aware of the signs and symptoms. You will notice signs such as constant thirst, frequent urination and extreme fatigue.

It has been suspected for a long time that type 1 diabetes, which is more common in younger people, is caused by a lack of insulin production. This could be due to an immune response that is over-responsive, such as a viral infection or respiratory viruses.

Numerous case reports from recent years have suggested that there is a link between type 1 diabetes and SARS/CoV-2 infected adults. However, evidence is less clear in children. A recent CDC report showed that children in the United States were 2.5 times more likely than adults to develop diabetes after a SARS-CoV-2 virus infection. However, it did not include other conditions, medications that can raise blood sugar levels, race, ethnicity, or other social determinants that could influence a child’s likelihood of developing COVID-19 or diabetes.

Gulseth, together with colleagues, linked individual-level data taken from all Norwegian national health registers for children and adolescents (1.202.174). Data were gathered from the Norwegian preparedness database, which is updated every day with individual-level data about PCR-confirmed SARS/CoV-2 infection, COVID-19 shots and disease diagnoses from primary and secondary care.

Children were followed from March 1, 2019, the start of the pandemic, until they were diagnosed of type 1 diabetes. They also had to turn 18 years old, die, or end the study (March 1, 2022), depending on when that occurred.

The risk of developing type 1 diabetes in young people within the first 30 days following PCR-confirmed SARS/CoV2 infection was examined by the researchers. They compared the group to the general population and to a group that was tested but not confirmed for the virus.

Over the two year study period, 424 354 children were found to have SARS-CoV-2 infections. There were also 990 cases of type-1 diabetes in the study’s 1.2 million participants.

After adjusting for age and sex, country, gender, geographical area, and socioeconomic factors the analyses revealed that young people who were infected with COVID-19 had a 60% higher chance of developing type 1 diabetes within 30 days. This was compared to people who have not been diagnosed with the virus or who have tested negative.

Gulseth states that it is not known what caused the increase in type 1 diabetes among young people after COVID-19. This requires more long-term monitoring and research to see if the risk could be different for children with different variants.

She says, “It’s possible delays in seeking care due to the pandemic might explain some increases in cases.” SARS-CoV-2, according to several studies, can attack the beta cells of the pancreas that make insulin. This could lead the development of type 1. It is also possible that inflammation from the virus can cause an exacerbation or recurrence of autoimmunity.

The study was observational and did not prove cause and effect. However, the authors acknowledge that there were other factors that could have affected the results, such as missing data or underlying conditions. The authors also noted that the analysis only included children who had taken a PCR test and not a lateral flow or asymptomatic infection test. This may have limited the conclusions that can be drawn.


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COVID-19 infection may increase type 1 diabetes risk, suggests a nationwide study of over 1.2 million children (2022 September 22).
Retrieved 22 September 2022
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